According to the Institute of Medicine’s Future of Nursing report, nurses should practice at the fullest extent of their training and education. The patient with a tracheostomy, gastrostomy, and PICC line requires a nurse with training in the care of these patients. Therefore, either the new nurse who just finished training in the ICU 6 months ago or the nurse with 10 years of ICU experience would be appropriate for the assignment. Because the patient appears to be stable from the description, the most appropriate nurse is the least experienced ICU-trained nurse. This will allow the more experienced ICU nurse to be available for the least stable patients. The patient requires far more care than an unlicensed assistive personnel can legally provide. It is unclear if the orthopedic nurse has been trained in the care of a patient with a tracheostomy, gastrostomy, and PICC line; therefore, he or she is not the most appropriate option.